Provider Demographics
NPI:1740576065
Name:ASAD, SYEDA SHAZIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SYEDA
Middle Name:SHAZIA
Last Name:ASAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26330 74TH AVE APT D8
Mailing Address - Street 2:
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1176
Mailing Address - Country:US
Mailing Address - Phone:732-379-0762
Mailing Address - Fax:
Practice Address - Street 1:26330 74TH AVE APT D8
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1176
Practice Address - Country:US
Practice Address - Phone:732-379-0762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP79266281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital